Overview
A digital weight loss intervention was implemented over a 12-month period in a primary care setting to see if provider counseling (usual care or intervention-specific) affects weight loss outcomes.
Organization Type
- Community health center
- FQHC
Tech Involved
- Electronic medical record
- Smartphone
- SMS
- Telephone
- Text messaging
Team Members Involved
- Dietician
- Health Coach
- Psychologist
Workflow Steps
- This digital health weight loss intervention included individualized behavioral goal setting, weekly telephone (texts or voice response calls) goal monitoring, skills training material, counseling calls, and individualized recommendations from providers.
- Participant eligibility criteria included if they had a BMI between 30.0–44.9 kg/m2; weighed less than 330 lb (weight limit for digital scale used in the intervention); and if they had a diagnosis of diabetes, hyperlipidemia, or hypertension.
- Behavior change goals were updated every two months and participants received calls from health coaches at least 18 times over the 12-month intervention.
Outcomes
- According to the participant report, the provider weight counseling was not associated with changes in weight during 0-6 months and 6-12 months.
- According to provider documentation, counseling was associated with changes in weight during the entire 0-12 months.
- Those who received intervention-specific counseling lost 4.0kg more weight than those who had no counseling.
- Those who received intervention-specific counseling lost 3.1kg more than those who had general weight counseling.
- Patient perception of provider empathy was associated with more weight loss between 6-12 months.
Unique Challenges
- A limitation was that counseling groups were not randomly assigned so a causal relationship could not be determined for counseling and weight.
- Individuals who had intervention-specific counseling may have become more engaged in coaching call discussions or striving to fulfill behavior change goals.
- Another limitation is that there was not verifiable data such as audio recordings or length of visit.
- There may have been confounding factors such as a stronger bonds between certain providers and patients affecting the impact of provider counseling.
- Participants may have remembered their clinic visit inaccurately .
- Providers may have reported their counseling incorrectly.
Sources
- McVay, M., Steinberg, D., Askew, S., Bennett, G.G. Provider counseling and weight loss outcomes in a primary care-based digital obesity treatment. J Gen Intern Med. 2019;34(6):992-998.
Innovators
- Megan McVay, PhD
- Dori Steinberg, PhD, RD
- Sandy Askew, MPH
- Gary G. Bennett, PhD
Editors
- Rebecca Tsai, BA
Location
North Carolina
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